ASBS: New Mammography Screening Guidelines Evaluated

May lead to more presenting with advanced disease, disproportionately affect non-whites

FRIDAY, April 29 (HealthDay News) -- Implementation of the U.S. Preventive Services Task Force (USPSTF) guidelines that recommend against routine screening mammography in women aged 40 to 49 years may lead to more women presenting with more advanced disease upon diagnosis and may disproportionately affect non-white women, according to two studies presented at the annual meeting of the American Society of Breast Surgeons, held from April 27 to May 1 in Washington, D.C.

In one study, Paul Dale, M.D., of the University of Missouri-Columbia, and colleagues reviewed medical record data from their tertiary referral center to identify women aged 40 to 49 years treated for breast cancer between 1998 and 2008. While the USPSTF recently recommended against annual mammography screening for 40- to 49-year-old women, unless the patient had a genetic mutation (BRCA1, BRCA2) or known chest radiation exposure, the investigators found that mammography screening in women aged 40 to 49 years detected smaller tumors with less nodal metastasis and resulted in improved survival.

In another study, Robert Aragon, M.D., of the Loma Linda University School of Medicine in California, and colleagues also evaluated the potential impact of the USPSTF recommendations on women aged 40 to 49 years diagnosed with breast cancer. The investigators found that screening at a younger age among non-Hispanic black, Hispanic, and Asian/Pacific Islander women was important for detecting earlier and more treatable cancers.

"Excluding 40- to 49-year-old women from screening could impact early diagnosis of hormone receptor positive, HER-2 positive, and triple negative tumors. The implementation of the USPSTF recommendations would disproportionately impact non-white women and potentially lead to more advanced presentation at diagnosis," Aragon and colleagues write.